In this podcast episode, Dr. Anne Truong, an intimate‑health physician, answers a caller’s question about why women over 50 experience painful intercourse. She explains that the primary driver is a sharp decline in three key hormones—testosterone, progesterone, and estrogen—during perimenopause and menopause. The loss of testosterone reduces libido, progesterone loss affects mood and sleep, and estrogen loss diminishes blood flow and vaginal tissue health, leading to reduced natural lubrication, tissue sensitivity, and occasional tearing or bleeding during penetration. Dr. Truong recommends practical sexual strategies such as longer foreplay to boost blood flow, the use of over‑the‑counter lubricants (specifically a cannabis‑infused Bliss Oil), and medical interventions including topical estradiol cream and systemic hormone replacement therapy (HRT) prescribed by a gynecologist, hormone specialist, or urologist. She stresses the importance of a gynecologic exam to rule out other conditions like lichen sclerosus, UTIs, or abnormal pap smears. Beyond sexual comfort, she notes that restoring hormone balance can protect against future health issues such as Alzheimer’s, heart disease, and bladder problems. The episode also addresses the relational impact on male partners, encouraging open communication and offering the Get Wood Now Boost program as a resource for men dealing with erectile dysfunction. Overall, the episode frames post‑50 vaginal pain as a treatable, hormone‑related condition rather than an inevitable part of aging.
Painful sex after 50 usually comes down to a massive drop in 3 specific hormones. I'm Dr. Anne Truong MD, and here is how to get your lubrication, comfort, and health back on track.
This podcast is for you, the modern man. I'm Dr. Anne Truong MD, your host. I'm an intimate health medical doctor and bestselling author of the book Erectile Dysfunction Fix. I'll do a deep dive into sexual health and performance and how it affects men of all ages and backgrounds. So let's get started and be sure to visit my website at sexualhealthformenpodcast.com for more information and resources from the show. See you on the inside.
Ma'am, why don't women want to have sex after the age of 50 years? My woman also complained that having sex, she feels pain as she has wound. Please explain the reason. So women have ED like men, but it shows in very different ways. We don't have a penis, so there's no erection, you may say. A woman penis is the clitoris. Right? The clitoris, it's her penis. It's a miniature penis. So women, even in the 40s, mid-40s, start to undergo perimenopause or the beginning of menopause. So what happened with perimenopause and even in women after 50, like your woman, is that hormone changes in her the same way hormone changes in you. So in women, they have 3 hormones to deal with. Estrogen, testosterone, and progesterone. And it's balancing, balancing of those three hormones. Believe it or not, the testosterone hormone is the most in her, followed by estrogen and then progesterone. So men have 100 times more testosterone than women, but women have 100 times more estrogen than men. And so that's what gives women and men those sexual characteristics. And when women after 50, The first thing that drops is their testosterone. And then the testosterone, well, responsible for her libido and her sexual arousal. And the second one that drops is progesterone. So that affects her mood and her sleep. Third one that drops is her estrogen, which is involved with blood flow. So what I'm trying to say is that for your woman after 50, her hormone drops. So when her hormones drop, it affects the lubrication down there. So it affects the lubrication around the opening of her vagina and also the lubrication around her clitoris. So it doesn't lubricate as well. And for a woman vagina, if it doesn't lubricate well, it's not moisturized, the opening of the vagina actually becomes sensitive and sometimes will even tear. So sometimes it will tear like at 6 o'clock. So the opening, because it's not lubricated, feels raw. It feels like sandpaper for her when she has sexual activity, especially during penetration. It feels like sandpaper. It feels raw. And sometimes it may even bleed around the opening of the vagina with penetration. So knowing that, for women, women need longer foreplay. They need longer foreplay. They still need blood flow down there to increase arousal, to increase the nerve in order for her to get aroused and get an orgasm. But she only needs 4 times more blood flow versus a man. He needs 40 times, 4-0, more blood flow down in the penis to get an erection. But women still need blood flow too. So what the blood flow does is that it brings in more sensation, but it also will help with the lubrication as well. So women need more time for foreplay for more blood flow. Even probably around 15 minutes or so. Okay. Some women are even longer. And when she's in menopause, all her hormones drop. So that's why she's not in the mood most of the time. And sometimes when her hormones drop, her vagina changes. It sags a little bit more. Her bladder sometimes will be irritated. Sometimes she'll have urinary tract infection or UTI. And the vagina tissue is not as moist. It's not as flexible. So intercourse becomes more uncomfortable, but that can be easily corrected with topical estrogen. So she can get some estrogen or estradiol from her doctor. It can even be a primary care doctor or her, her gynecologist. Estradiol. She can get estradiol cream and she could just put around her vagina, especially on the opening of her vagina and also around her lips area. That will help with the lubrication and that will help with healing of the vagina. It'll help her tolerate intercourse. But she also needs to be on hormone replacement therapy. She needs to get her estrogen. She needs to get her testosterone. She needs to get her progesterone. So she can see a hormone specialist doctor. She can see her gynecologist. However, not all gynecologists know how to do hormones or not as welcoming to hormone replacement therapy. However, that's changing. But again, that depends on the doctor and the willingness and comfort level to do hormone replacement therapy. Urologists do hormone replacement therapy as well too. Or you can just go to a hormone specialist doctor. Well, she's going to need some topical estrogen down there to lubricate. She needs to put it around her vaginal opening to lubricate. Tape so that way she doesn't hurt. And literally within like a week, it'll be changed significantly within a week, and that intercourse will be a lot more comfortable for her. It actually can be easily corrected. And for women, for them to be able to enjoy intercourse and have orgasm again, it's really about hormone. But also have a gynecologist look down there as well to see if there's any other thing going on, any other medical condition going on down there. There's some cases she may have lichen sclerosis. If she does have a uterus, make sure she gets pap smear every year or every 3 to 5 years depending on her risk factors. And so the main thing is go see a doctor, ask for some topical estrogen, but there's also some over-the-counter lube as well too that she can use. There is one that is in our store called Bliss and it lubricates well. There you go. It's called Bliss Oil for men and women. It is cannabis-infused oil and it actually lubricates very well in the vaginal opening. And she should also put this on her clitoris as well too. But I recommend this Bliss and you can get this at ednomore.com. Try it out, let me know. But if you get that Bliss Oil, it will help her lubricate that quite a bit. Okay. I hope that helped, but let her know it can be correctable. It can be treated. She doesn't have to live with it. And in fact, for her, it can be easily treated within a week, unlike ED. So for women, it is particularly simple to reverse. It's just getting the word out there. So thank you for asking that question and for me to answer that because It may help more people than you think because a lot of women suffer silently and this sometimes will actually affect your relationship too because she's uncomfortable. She doesn't want to do it and then you don't want to push her, but you didn't know that this is due to hormone and then you don't want to push her and then you avoid sex. She avoids sex. No one talking to each other. And if you're not getting an erection, if you're not debating, then you may even put yourself at risk for atrophying of that penis and even put yourself at risk to even get ED unless you use a penis pump. Then it can really affect your relationship as well. I know relationship is more than just physical, but the physical part is also an important part of the whole relationship as well. So just know, for her, it can be treated. She just need to know and go ask her doctor. Okay. And we're just not talking about sex. We're really talking about her health too, because if she gets hormone replacement therapy with her estrogen, her testosterone, her progesterone, it will also protect her against Alzheimer's in the future, heart disease in the future, and also bladder issue down there in the future as well. So it's not just getting hormones for sexual activity. Is really her getting hormone for her health and her quality of life. Okay, modern men, you are not alone and you don't have to suffer anymore. ED can feel isolating, frustrating, and even defeating. The endless guessing, the quiet shame, the weight of not feeling like yourself. It's exhausting. But here's the truth. You are not broken. You are not alone. You don't have to figure this out alone anymore. The Get Wood Now Boost program is your step-by-step path to sexual confidence and restoration. No more suffering in silence. No more trial and error. Just real solution, real result, and the confidence you deserve. It's time to take back your power, on your terms. Let's get this journey started together. Check out the course at getwoodnow.com. I'll see you there.
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